American Hospital Association October 22, 2021
Medicare Advantage plans provide essential health insurance coverage for approximately 22 million Americans, or about one-third of all Medicare beneficiaries.
However, for many individuals with MA plans — and millions more who have commercial insurance — prior authorization rules can deny or slow down needed care, putting patients at unacceptable risk.
Prior authorization is a process in which a provider, on behalf of a patient, requests approval from the patient’s insurer before delivering a treatment or service. It can be a valuable tool when used appropriately; unfortunately, many commercial health plans apply prior authorization requirements in ways that create dangerous delays in care, contribute to clinician burnout and drive up costs for the entire health care system.
The AHA...
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